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Imaging
Center for Animals
 
STAFF
Radiologist
Dr. Renée Léveillé
Dr. Elisabeth Girard
Technicians
Jennifer Woods, CVT
Jolene Ebel, CVT
Kristy N. Mroska, RT(R), MR, ARRT
Lauren Calandra
Sara Jendro
Adrienne Allen
Amy Junker
Transcriptionist
Sue Calandra
Coordinator
Heather Coughlin
SERVICES
Diagnostic Radiology (Computed Radiography/Fluoroscopy)
Sonography
Computed Tomography
Scintigraphy
Magnetic Resonance Imaging (MRI)
PACS
I-131 Therapy
Samarium-153 for Treatment of Bone Tumors
The Imaging Center for Animals (ICA) was founded on the premise that effective treatments require precise diagnosis. Dr. Léveillé and Dr. Girard are two noted people helping to make sure that happens.
Our goal is to provide a comprehensive imaging service for the Chicago area. The Imaging Center has two x-ray machines for Diagnostic Radiology, and one Fluoroscopy suite for dynamic studies as well as interventional procedures.
We also offer Advanced Sonography examinations, including Echocardiography and Interventional Procedures (FNA, biopsies, chemoembolization).
Our CT scanner is capable of spiral CT imaging, as well as conventional scanning.
We are also equipped with a gamma camera for Scintigraphy (nuclear medicine). It can often detect abnormalities before they become apparent on other imaging modalities.
A 1.0 Tesla in-house magnet is available for MRI studies on a daily baiss.
As of June 2004, the Imaging Center became a filmless environment; all imaging modalities are linked to a PACS system where all the images are digitally available.
In addition to these diagnostic modalities, the Imaging Center provides Iodine-131 treatment for cats and dogs suffering hyperthyroidism and thyroid carcinomas as an alternative to thyroid gland surgery.
Of all the imaging modalities, Diagnostic Radiology remains the primary diagnostic tool. The newer x-ray equipment is more powerful and reduce the exposure of radiation for the patient and the personnel. In addition to the routine radiographic studies, the Imaging Center for Animals offers all contrast procedures, from an upper GI series, IVP, arthrogram to a myelogram.
Using the Computed Radiography technology, all the radiographic studies are obtained in the digital format and transferred to our PACS system. The entire Imagaing Center is filmless. Computed Radiography allows higher quality of the radiographic studies, increases efficiency in daily workflow, and integrates all imaging studies for each patient. There are no more lost films!
The C-arm fluoroscopy unit allows dynamic studies including evaluation for tracheal collapse, swallowing dysfunction, IVP for ectopic ureters. Using a subtraction technique, dedicated vascular studies such as portogram, abdominal or peripheral vascular anomalies can easily be performed.
The unit can be rotated around the patient to obtain different views without changing the position of the animal. It is mobile and can be brought to the surgery suite where fluoroscopic orthopedic guidance may be needed.
The dynamic visualization and mapping of the vascularization of a patient allows interventional procedures to be performed such as embolizations of portosystemic shunts, arterio-venous malformations, chemoembolizations, and tracheal stents.
Collapsed Trachea and Tracheal Stent
We also offer a non-surgical procedure as a treatment of tracheal collapse: Tracheobronchial stent. When medical management has been unsuccessful, surgical correction (tracheal ring, placement of extraluminal devices…) may be offered but complications may develop. Several intraluminal stents have been developed specifically for airway collapse in humans and are now available in veterinary medicine. When the patient is referred to ICA, the magnitude of the tracheal collapse will be evaluated under fluoroscopy, and then the appropriate stent will be deployed. The procedure provides immediate relief from dyspnea. |
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The Imaging Center for Animals has acquired a Sequoia ultrasound unit from Acuson.
The Sequoia system provides unparalleled contrast, temporal and color resolution. It affords color Doppler scanning, power Doppler and computer-assisted imaging (cine clips). It is equipped with a wide range of specialized transducers, to allow imaging of patients ranging in size from a ferret to a Great Dane.
A unique feature of the Sequoia is its Perspective Display or Extended Field of View which allows panoramic imaging. It allows full visualization of areas of interest that are much larger than the footprint of the transducer. For example, both lobes of the thyroid gland and the trachea can be displayed at the same time, large abdominal masses can be visualized in relationship with blood vessels and other abdominal organs. It provides unique additional dimension to real-time scanning.
The most common applications are:
- Abdominal Sonography: Visualization of the internal architecture of each abdominal structure provides information on parenchymal lesions that are not detected on radiographs (x-rays).
- Thoracic sonography: Neck, mediastinal, or peripleural pulmonary masses can be imaged and biopsied for definitive diagnosis.
- Echocardiography: Allows a dynamic evaluation of the anatomy, motion and function of the heart. 2D, M-mode, Color Doppler is particularly useful in the diagnosis of acquired valvular disease and congenital heart disease.
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The Imaging Center for Animals operates a Phillips Medical Tomoscan-M scanner that provides Conventional and Spiral/Helical Computed Tomography.
Conventional CT allows high-resolution axial images of the brain, spine, bones and abdomen. The images can be displayed using a window that is more appropriate for the evaluation of bone, soft tissues, or both. The images can then be reconstructed in different planes (sagittal, coronal) for additional evaluation. Injection of iodinated contrast material is used to enhance vascularized tissues/structures, such as tumors. The anatomic sites routinely imaged include:
- Brain and nasal region
- Spine
- Lumbosacrum
- Pelvis for intrapelvic masses
- Elbow joint for fragmented medial coronoid process
- Shoulder joint
Compared to Conventional CT where the images are obtained slice by slice, with Spiral CT, the patient on the table is advanced through the gantry as the CT tube moves in a spiral movement around the patient, simulating the threads of a screw. Applications for Spiral CT imaging include:
- Thoracic studies for the detection of small pulmonary tumors and lymphadenopathy.
- Abdominal studies to determine the location of adrenal masses and other tumors in relation to the main vessels.
- Abdominal for pancreas, adrenal glands, prostate, and kidneys, etc.
- CT angiography. IV administration of contrast media, allows for the maximum opacification of vessels without need for selective catheterization.
Scintigraphy allows the functional evaluation of different organs or systems. It is more sensitive to physiological changes compared to diagnostic radiology and sonography.
The most common applications are:
- Portosystemic Shunt: It offers a non-invasive, accurate method of detecting shunts. The procedure consists of depositing a radionuclide (99m-Technetium) in the colon followed by acquisition of several images over a 3-minute period. The magnitude of the shunt can be estimated but it is not designed to determine the actual site of the shunt.
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Bone Scans: They are used to localize metastatic bone lesions and in finding the cause of obscure lamenesses.
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GFR for renal function evaluation: The glomerular function rate (GFR) is directly proportional to the number of functioning nephrons. It allows for detection of renal dysfunction prior to elevation of BUN or creatinine. It is an important consideration prior to nephrotomy or nephrectomy.
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Thyroid Scans: These scans detect the presence of functional thyroid tissue in dogs and cats.
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Leukocyte scans: The radionuclide is attached to the white blood cells (leukocytes) of the patient and its distribution, within the body, is then imaged. Areas of infection or inflammation will concentrate the uptake. It may be useful in cases of fever of unknown origin, or to detect the presence of abscess.
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Lymphoscintigraphy: It is a rapid, non-invasive imaging modality for evaluating lymph nodes and lymphatic drainage, particularly from peripheral areas, such as the extremities.
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Pulmonary Scintigraphy: In combination with thoracic radiographs, pulmonary scintigraphy (perfusion) is used for assessing patients suspected of having pulmonary thromboembolism.
A new Magnetic Resonance Imaging (MRI) suite acquired and installed in-house by the Imaging Center completes the diagnostic imaging facility. It is one of the most sophisticated imaging tools in modern medicine because of its ability to produce images that show finer details. It provides excellent differentiation between different types of soft tissues compared to radiographs and computed tomography (CT). MRI can be used to visualize the brain, spinal cord, eyes, nasal cavities, inner ears, abdominal organs, or other soft tissues, and bone. A myelogram can be obtained without injecting any contrast material.
It offers good resolution, excellent contrast, creates multilevel images in the same plane and allows imaging in different planes. It is the most sensitive imaging study for early disease detection and cancer staging, and is used to clarify abnormalities of uncertain significance detected by other imaging modalities.
The MRI images are constructed from signals emitted by the hydrogen protons of the body that are exposed to a magnetic field and radio wave; MRI is then able to look at the chemistry of the different tissues. Diseased tissues react differently than normal tissue, and this difference in tissue response provides the base for MRI imaging. Different protocols can be used to amplify the signals of different tissues or pathologies. Because the acquisition of the images uses a different technology, high quality images in different planes can be obtained without the need of reconstruction.
The most commmon applications are:
- Neurologic Exams: Brain and Spine (including myelogram)
- Orthopedic Exams
- Opthalmic Exams
- Defining Soft Tissue Margins
- Delineation of Tumors
- Angiography/vascular imaging (ie portogram)
As of June 2004, the Imaging Center became a filmless environment: all of the images (radiographs--including fluoroscopy/angiographic studies), sonograms, CT, MRI) are digitally available and linked to a PACS system.
This filmless environment allows all of the imaging studies on a patient to be retrieved in a matter of seconds and easily compared to each other. This is done through a PACS system where 18 viewing stations allow specialists throughout the hospital to have access to this bank of images at the same time. It not only eliminates the problem of losing films, the PACS system allows us to send (via Internet) images of the lesions to referring veterinarians, as needed. It facilitates discussion of cases, as the specialists and referral veterinarians can visualize the images together, at the same time, remotely, even if they are in different clinics/hospitals: any image, anywhere, anytime!
Radioiodine therapy is the least
invasive, the safest, and the most effective way to treat hyperthyroidism in
cats. It avoids the inconvenience of daily, oral administration and side
effects associated with antithyroid drugs (such as Tapazole), as well as the
risks and post-operative complications associated with anesthesia and surgical
thyroidectomy. More than 95% of cats will be cured by
a single injection. The remaining small percentage of cats can be treated a
second time safely if the thyroid levels remain high at >6 months
post-injection. The I-131 is absorbed and metabolized by the hyperactive
thyroid tissue only (even ectopic tissue) and destroys the abnormal
hyperfunctioning thyroid cells. The normal cells are suppressed by the
hyperactive tissue, therefore they don’t uptake the I-131 and are spared. The
I-131 does not travel more than 3 mm in tissue therefore adjacent structures are
not affected. Normal thyroid levels are usually reached within a month.
PRE-REFERRAL DATA
A thorough
physical exam, complete blood work including CBC, Chemistry, and T4, thoracic
radiographs, and a urinalysis will be required within 1 month of admission. If
any underlying cardiac abnormalities are detected, further work-up of these
patients by means of an ECG or echocardiography, may be necessary. Cats with
renal failure or other chronic illnesses should be stabilized as much as
possible prior to treatment. In this way we hope to avoid complications during
hospitalization following the radioiodine treatment.
PROCEDURES
Our protocol includes an imaging study
of the thyroid prior the I-131 therapy. Not only will the scintigraphic study
confirm the diagnosis of hyperthyroidism in cats that do not have a palpable
thyroid nodule, but also in those cats which have had a relapse of
hyperthyroidism after thyroidectomy, and it will also evaluate for the
possibility of ectopic thyroid tissue. The scintigraphic study is done under
sedation.
The I-131
is administered as a subcutaneous injection.
Due to the radioactive
nature of the I-131, the patient is obligated to remain within the shielded
facility, approved by the state, at all times during the established days of
hospitalization (approx. 5 days). Safety regulations do not allow any visitors
in the treatment/housing area. The radiologist will monitor each patient
everyday. The owners will be updated on a daily basis on the status of their
pet by a technician. The referring veterinarian will receive a notification at
the release of the patient.
POST-TREATMENT PROCEDURES (at home)
At the time of release, the Radiologist will meet with the owner and explain the
post-treatment procedures:
For the next 2
Weeks:
Keep your cat indoors. Scoop urine and fecal clumps from the litter box
twice daily. Use a flushable litter (ICA will provide one 10 lb. bag) and
flush all clumps down the toilet. Avoid splashing and flush 3 times.
Always wear latex gloves (ICA will provide) when handling your cat’s waste
products, bodily fluids and when cleaning the litter box. Place gloves and
any objects that have been in contact with your cat’s urine or feces in a
double lined garbage bag in a remote area of the house away from children
and other animals.
Keep minors (< 18 years of age) and pregnant
women from coming into contact with your cat or its waste products.
Keep your cat in a carrier during any transport to avoid contamination of
your vehicle by your cat’s urine or feces
After
2 weeks from release, you and your cat can resume normal activities and you may
stop flushing waste products.
FOLLOW-UP
with referring veterinarian
Normal thyroid levels are
usually reached between 1 and 3 months (up to 5 months).
More than 95% of cats will be cured by a single
injection. The remaining small percentage of cats can be treated a second time
safely if the thyroid levels remain high at > 6 months post-injection.
Follow-up bloodwork and T4
levels at 1, 3, 6, and 12 months are recommended. This can easily be done at
your primary veterinarian’s clinic.
Samarium-153 for treatment of Bone Tumors
We also offer a new treatment for Bone Tumors: bone-seeking, radioactive drug known as Samarium-153. The treatment itself consists of an injection of Samarium-153, a radioactive isotope that targets rapidly growing bone cells. Palliative (pain relief) and even curative effects have been demonstrated in dogs using Samarium to treat a variety of skeletal neoplasia, both primary (osteosarcoma, chondrosarcoma) and metastatic. During the two-day period when the dog’s urine is highly radioactive, it is kept in isolation and monitored by Radiology staff. After a bone scan, which allows for a more accurate evaluation of the bone and tumor, the dog is released back to the owner. During the following six weeks, the Samarium remains within the tumor emitting beta rays that destroy the tumor cells.
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